Nevada Health Link Non-Profit Partner Presentation
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Nevada Health Link Non-Profit Partner Presentation
- 2. Agenda 1. The ACA and Nevada Health Link 2. Your Role 3. Online Marketplace Overview 4. Key Points to Convey 5. Questions You May Hear 6. Resources 7. Q&A
- 3. The ACA and Nevada Health Link
- 4. The Affordable Care Act (ACA) • A law passed by the U.S. government in 2010 • Aims to lower cost of health care • Requires all Americans to have insurance by 2014 • Applies a tax penalty (a fine) for those without coverage 4
- 5. Nevada Health Link • Nevada’s official Health Insurance Exchange • Help residents of Nevada find affordable health insurance • Online marketplace to shop for and compare plans • Enroll residents of Nevada in quality, income- based plans 5
- 6. Your Role
- 7. Talk to About Nevada Health Link • Spread the word • A new and easier way to buy health insurance • Talk to the uninsured and underinsured residents of Nevada • People over 65 are not eligible for subsidies to lower the cost of health insurance. 7
- 8. Our Message • Under- and uninsured now have a new way to shop for and buy affordable insurance • Won’t be denied for a pre-existing condition • Visit NevadaHealthLink.com to learn more 8
- 9. Partner Tools and Collateral • Nevada Health Link materials and website • Helpful tools from government and other organizations • Contact us if there’s a tool you’d like to use that we haven’t provided you • 1-877-572-7263 or HealthLinkPartner@kps3.com 9
- 10. Navigators, Enrollment Assisters & CACs • Navigators: community education and enrollment • Enrollment Assisters: can enroll individuals one-on- one • Certified Application Counselors: can enroll individuals • To find in-person help in your area, visit NevadaHealthLink.com 10
- 12. How It Works 1. Fill out an application at NevadaHealthLink.com 2. Find out if you qualify for financial help 3. See a list of different plan options from different insurance carriers 4. Compare your options 5. Choose the plan that’s right for you 12
- 13. Online Marketplace Sample View
- 14. Plan Categories 14 Tier Cost Platinum Most Expensive Gold More Expensive Silver Base Bronze Less Expensive Catastrophic Least Expensive • With bronze plan, pay lower monthly premium and more when you receive care • With gold plan, pay higher monthly premium and less when you receive care
- 15. Income-Based Health Insurance Annual Income at 100% of the Federal Poverty Level and Other Levels (Calendar Year 2013) 15 Family Size 138% FPL 200% FPL 300% FPL 400% FPL 1 $15,856 $22,980 $34,470 $45,960 2 $21,404 $31,020 $46,530 $62,040 3 $26,951 $39,060 $58,590 $78,120 4 $32,499 $47,100 $70,650 $94,200 5 $38,047 $55,140 $82,710 $110,280 For each additional person add $5,548 $8,040 $12,060 $16,080
- 16. Help Covering Costs Monthly Premiums Under the Second Least Expensive Silver Level Plan (Calendar Year 2013) 16 Family Size 138% FPL 200% FPL 300% FPL 400% FPL Percent of Income 3.29% 6.3% 9.5% 9.5% 1 $43.53 $120.65 $272.89 $363.85 2 $58.76 $162.86 $368.36 $491.15 3 $73.98 $205.07 $463.84 $618.45 4 $89.21 $247.28 $559.31 $745.75 5 $104.44 $289.49 $654.79 $873.05 For each additional person add $15.23 $42.21 $95.48 $127.30
- 17. Same Application, Different Results 17 Ben applied and bought insurance from the Marketplace. Alice applied and got Medicaid coverage for herself and her daughter. James applied and bought insurance from the Marketplace and qualified for the new tax credit that lowers his monthly premium right away.
- 18. What’s Covered 18 Essential Health Benefits Ambulance Services and Care Mental Health and Substance Abuse Disorder Treatment Preventive and Wellness Services Emergency Service Prescription Drugs Chronic Disease Support Hospitalization Rehabilitation and Habilitation Services and Devices Pediatric Services Including Dental and Vision Care Maternity and Newborn Care Lab Services
- 19. Key Points to Convey to Your Community
- 20. Important Dates • Can sign up on NevadaHealthLink.com starting in October 2013 • Sign up by December 15to have insurance coverage on January 1, 2014 • Sign up before open enrollment closes on March 31, 2014 20
- 21. October 2013 • Visit NevadaHealthLink.com anytime to find more information about what to expect when you enroll beginning October 2013 21
- 22. Health Insurance Plans • Variety of plans for you to compare • Choose a plan that fits your needs • Financial help and subsidies • All information in clear language, so there’s no guesswork 22
- 23. Who Nevada Health Link Covers • Any resident of Nevada looking for health insurance • Can’t be turned away for pre-existing conditions • Only requirement is that you’re legally present • Your application won’t trigger INS investigation 23
- 24. Help is Available • Live online chat • Toll-free call center – 855-7-NVLINK (855-768- 5465) • Navigators and Enrollment Assisters • Search for in-person help on NevadaHealthLink.com • Local Insurance Agents 24
- 26. What is Insurance? • You pay each month for insurance (a premium) • Covers medical bills, including preventive and emergency care • Allows you to get the care you need when you need it for you and your family • Helps you to avoid big medical bills and debt 26
- 27. Why Do I Need Insurance? Protect Yourself and Your Loved Ones 27
- 28. Why Nevada Health Link? • Income-based plans • Can’t be turned away for pre-existing conditions • Essential health benefits 28
- 29. Full list of FAQs, for individuals/families and partners is available at NevadaHealthLink.com 29
- 30. Resources
- 31. Tools and Resources • Non-profit and Community Partner Guide • NevadaHealthLink.com • Call 1-877-572-7263 • Email HealthLinkPartner@kps3.com 31
- 32. Questions?
Editor's Notes
- Insurance protects you and your family, and the U.S. government believes that all citizens should be protected. In 2010, the U.S. government passed the Affordable Care Act, a law that aims to cut the cost of health care and increase the number of people with insurance. This new law requires everyone to have health insurance by 2014. If you don’t have insurance by March 31, 2014, you will be fined by the IRS.
- Operated by the State of Nevada, Nevada Health Link is here to protect Nevadans from that penalty by helping them find income-based health insurance. In October 2013, Nevada Health Link will open its online marketplace, NevadaHealthLink.com, where people will be able to shop for income-based health insurance plans. People will be able to shop for, compare and buy health insurance all at NevadaHealthLink.com. As the state’s official health insurance exchange, Nevada Health Link’s goal is to enroll all Nevada residents into quality health insurance plans.
- As a community partner your role is simple, help us spread the word. If you aren’t a Navigator or Assister you wont’ be able to enroll people in a plan, but you can help by letting people know that a new and easier way to buy health insurance (that fits their budget) is on the way. Talk with your clients and community about Nevada Health Link and let them know Nevada Health Link will make health insurance available to all Nevadans.All residents of Nevada can enroll through Nevada Health Link, but our primary focus is on people in Nevada who are uninsured and underinsured. This can be anyone, from individuals to families. People over the age of 65, however, are not eligible for subsidies through Nevada Health Link and should be referred to Medicare.
- We want to let the uninsured and underinsured know that if they don’t currently have insurance because of a pre-existing condition or because they can’t afford it, starting this October they will be able to find an income-based health insurance plan at NevadaHealthLink.com. Even though people won’t be able to enroll until October 2013, they can still visit NevadaHealthLink.com for more information about what to expect when they do enroll.
- Our partner guide, training video and website can provide you with a lot of information. Nevada Health Link has also produced consumer-facing materials for you to hand out to people as you talk to them about Nevada Health Link.In addition to Nevada Health Link’s materials, there are many other tools and informational pieces in existence produced by the federal government and other organizations, such as Consumer Reports, that are fine to use. We ask, however, that you let Nevada Health Link approve all materials about the online marketplace in Nevada prior to utilization. If there is a tool you’d like to use that we have not directly provided you, please contact us.
- As a community partner, you can’t enroll people in a plan through NevadaHealthLink.com, but there are other partners that will be able to help people if they don’t want to go through the application and enrollment process alone. Navigators and Assisters will be available to help people enroll and buy health insurance through the online marketplace. The main difference between navigators and assisters is that Navigators go out into the community to educate individuals and groups about Nevada Health Link and are trained to help them enroll, and Assisters work one-on-one with people, sitting with each enrollee and helping them enter information into the online marketplace. Certified Application Counselors can also help individuals enroll in health plans through NevadaHealthLink.com. A list of Navigators, Assisters and CACs and their locations can be found on NevadaHealthLink.com.
- First, people will visit NevadaHealthLink.com to fill out an application.Once their application is complete, NevadaHealthLink.com will let them know if they qualify for financial assistance or subsidies. Once that is determined, NevadaHealthLink.com will give them a list of different insurance plan options. People can compare these plans by price, coverage and provider network. All of the information about each plan will be available in clear, easy-to-understand language, so there’s no guesswork about what’s covered and how much it costs.
- This is an example of what people will see after their application is complete. Similar to shopping for flights or a hotel online, they’ll be able to use various tools to compare their different plan options. They can narrow down their options by provider network, carrier or monthly costs. They can even calculate what their costs will be for the year based on how many doctors visits, prescriptions, etc. they think they’ll need for each person on their plan.
- In order to make it even easier for people to find a plan that’s right for them, Nevada Health Link will categorize the plans into the following groups: platinum, gold, silver and bronze. This chart represents the levels of coverage and their relative cost.A plan’s monthly cost increases based on its metal tier. For example, if you purchased the bronze plan, you’d pay less each month for your premium, but more when you receive medical care. If you purchased the gold plan, which has a higher monthly premium, you’d pay less when you receive medical care.Catastrophic plans are only available to those individuals who are under 30 years of age.
- How much you pay each month for health insurance will be based on your annual household income. This means that people who have not previously been able to afford health insurance because of cost will now be able to sign-up for high-quality health insurance plans.This sample chart shows different income levels relative to household size and the Federal Poverty Level. So, for example, if you’re a family of four in the 200% FPL group, you make around $47,100 a year.
- If you’re that same family of four, making around $47,100 a year, you’ll be paying $247 a month for insurance for your entire family. People may be eligible for different subsidies and financial helpbased on their household income. One of the subsidies available is called the Advanced Premium Tax Credit. Once you fill out your application on NevadaHealthLink.com, we’ll tell you if you qualify for this credit. If you do qualify, this credit will reduce your costs right away. The money will go directly to your insurance company, so you will be paying less on your monthly bills right from the start.Remember, these credits and subsidies are only available through Nevada Health Link.
- Different plans work better for different people. If someone has a chronic illness or fills a lot of prescriptions drugs regularly, they might choose to pay more each month and purchase the gold or platinum plan, so they pay less for your care and prescriptions. If on the other hand, someone is young and healthy, they might choose to pay less each month and purchasethe bronze plan and pay more when they do receive medical care. Some people may qualify for other government-sponsored insurance programs, like Medicaid. If someone qualifies for subsidies or public insurance programs (like Medicaid or Nevada Check Up), Nevada Health Link will alert them and help enroll them in those programs if they wish. If they qualify, they will not need to fill out another application.Nevada Health Link will not pre-populate applications for non-insurance government programs, such as SNAP and TANF.
- Under the Affordable Care Act, all qualified health insurance plans will have to cover certain Essential Health Benefits. These benefits include:Ambulance Services and CareEmergency ServicesHospitalizationMaternity and Newborn CareMental Health and Substance Abuse Disorder TreatmentPrescription DrugsRehabilitation and Habilitation Services and DevicesLab ServicesPreventive and Wellness Services and Chronic Disease SupportPediatric Services, Including Dental and Vision Care
- NevadaHealthLink.com is here now to provide education and information, but people won’t be able to use it to sign up for health insurance until October 2013. People will be able to enroll in health insurance coverage at NevadaHealthLink.com from October 2013 through March 2014. If yousign up for insurance by December 15, 2013, your coverage will begin on January 1, 2014.Enrollment closes for individuals on March 31, 2014. If people don’t have health insurance, they’ll need to choose and enroll in an insurance plan or obtain government funded health coverage before this date if they want to avoid the tax penalty.
- Our website is a great resource for people who want to learn more. Until October 2013, people can visit NevadaHealthLink.com to find more information about what to expect when they do apply for and select health insurance. Then in October 2013, NevadaHealthLink.com will become the online marketplace where people can shop for and buy insurance plans.
- There will be a variety of certified health insurance plans available at NevadaHealthLink.com, and peoplewill be able to compare plans by price, coverage and provider networks. The cost of a person’s health insurance plan will be based on their annual income, and there will be financial help for those who need it. All of the information about each plan will be available in clear, easy-to-understand language, so there’s no guesswork about what’s covered and how much it costs.
- Nevada Health Link is here to help any resident of Nevada looking for health insurance, whether they already have it or not. No one will be turned away for pre-existing conditions, like diabetes or cancer. The only requirement to apply for and purchase health insurance on NevadaHealthLink.com is that you are legally present in the U.S. and living in the State of Nevada. Filling out an application on NevadaHealthLink.com will not trigger an immigration investigation through INS.
- We want everyone to know that help is available every step of the way. As people search for and compare insurance plans, they can ask questions or find help through live online chat or by calling our toll-freecall center. There will also be trained Navigators, EnrollmentAssisters, and other in-person assistants to help people enroll. They will be available to help youenroll and buy health insurance through NevadaHeathLink.com.Throughout the next few months Navigators, will be going out into communities around Nevada to educate people about Nevada Health Link and come October, to help them enroll. Beginning in October, Enrollment Assisters will work one-on-one with individuals and families, sitting with each enrollee and helping them enter information into the online marketplace. People will be able to easily find an Enrollment Assister or other in-person help in their community by searching on NevadaHealthLink.com.If individuals have questions that Navigators and Enrollment Assisters cannot answer, they may also visit a local insurance agent or broker.
- Now we’ll go through some common questions you may hear and how to answer them.
- Health insurance helps pay for certain health services so you don’t have to pay the entire bill. Having health insurance helps you avoid high medical bills and debt because in exchange for the amount of money you agree to pay the insurance company each month (your premium), the insurance company agrees to pay for part of your larger medical bills. The cost of your insurance plan can be broken down into these key components: premium, deductible, copay and co-insurance. These parts vary depending on the plan you choose.
- Health insurance protects you and your loved ones if you get sick or injured. Insurance helps to keep you and your family healthy. If you have insurance, you’ll be able to get preventivecare (like regular check-ups and screenings) so you and your family will be sick less often. Preventative care also helps catch health issues or concerns before they develop into serious problems.It also protects you financially: it protects you from having to pay large medical bills that you could incur. Health insurance helps cover the cost of your medical bills, which is especially important if you have to miss work due to illness or injury.
- Many of you have had had trouble shopping for or buying insurance in the past. Nevada Health Link is offering a new and different way of buying health insurance, and the ACA has changed the way health insurance is handled in the US.The plans offered at NevadaHealthLink.com will be high quality and how much you pay for them will be based on your income. You can not be turned away if you have a pre-existing condition, like diabetes or cancer. And all plans will cover those Essential Health Benefits we went over, including prescription drugs, check-ups, maternity care and hospital visits.
- There are more FAQs and answers available in the partner guide, training video and NevadaHealthLink.com. If you have trouble answering someone’s questions, or they just want some more information, send them to NevadaHealthLink.com
- As a partner, if you need any more information or have any questions, please take a look at our partner guide, training video and website. If you have any questions or need additional resources, you can contact us at 1-877-572-7263 or email us at HealthLinkPartner@kps3.com. Please visit NevadaHealthLink.com regularly to stay up-to-date on all the latest information regarding Nevada Health Link.
- Q&A session after presentation has concluded.